New Attached are the 2020-2021 Diabetes Forms. June 1 ...

Dear Parent or Guardian:

Every year, your school nurse needs new diabetes forms to be filled out and signed by both you and your child's doctor. Updated information lets the school nurse know if your health care provider has made any changes in the past year to your child's medicine or treatment. The school nurse needs this information to properly treat your child.

Attached are the 2020-2021 Diabetes Forms. Please submit these forms as soon as possible. It is recommended to submit the Diabetes Medication Administration form (DMAF) by June 1, 2020, or as soon as possible. This allows the school health physician time to review the forms and ensures that your child will receive approved services at the start of the school year in September 2020. Once your child's doctor has completed the diabetes forms, please attach a small photo to the upper left hand corner of the form for proper proof of identity of your child.

Mail the Diabetes Medication Administration Forms to:

DMAF Coordinator New York City Department of Health & Mental Hygiene Office of School Health Gotham Center 42-09 28th Street, CN-25 Queens, New York 11101-4714

Or you can fax the forms to 347-396-8945 or 347-396-8932. Please be sure to fax both sides of the forms.

If your child also has a school-based 504 Accommodation plan in place, it is advised to submit your 504 renewal request forms to your school's 504 Coordinator as soon as possible. The 504 Team needs this information to make sure that appropriate accommodations are provided for your child. This will enable a 504 team meeting to be held before the start of the school year and an accommodation plan to be in place for the 2020-2021 school year.

If you have any questions, please speak to your school 504 Coordinator, or call 718-310-2405.

Thank You,

Dr. Cheryl Lawrence Medical Director Office of School Health

OSH-21 DMAF ReAuth rev 05.2020

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